How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $234.42 Median $234.42 Typical High $234.42 | Facility | None | $234.42 | $234.42 | $234.42 |
Aetna Setting Professional Modifier None Typical Low $123.03 Median $234.42 Typical High $245.47 | Professional | None | $123.03 | $234.42 | $245.47 |
Cigna Setting Facility Modifier None Typical Low $165.96 Median $338.84 Typical High $338.84 | Facility | None | $165.96 | $338.84 | $338.84 |
Cigna Setting Professional Modifier None Typical Low $309.03 Median $398.11 Typical High $467.74 | Professional | None | $309.03 | $398.11 | $467.74 |
Hally Health Setting Professional Modifier None Typical Low $295.12 Median $323.59 Typical High $371.54 | Professional | None | $295.12 | $323.59 | $371.54 |
Medica Setting Facility Modifier None Typical Low $208.93 Median $331.13 Typical High $1,380.38 | Facility | None | $208.93 | $331.13 | $1,380.38 |
Medica Setting Professional Modifier None Typical Low $151.36 Median $257.04 Typical High $776.25 | Professional | None | $151.36 | $257.04 | $776.25 |
Midlands Setting Professional Modifier None Typical Low $354.81 Median $398.11 Typical High $398.11 | Professional | None | $354.81 | $398.11 | $398.11 |
Midlands Setting Facility Modifier None Typical Low $338.84 Median $338.84 Typical High $338.84 | Facility | None | $338.84 | $338.84 | $338.84 |
Midlands Setting Professional Modifier None Typical Low $309.03 Median $501.19 Typical High $501.19 | Professional | None | $309.03 | $501.19 | $501.19 |
United Setting Facility Modifier None Typical Low $141.25 Median $436.52 Typical High $831.76 | Facility | None | $141.25 | $436.52 | $831.76 |
United Setting Professional Modifier None Typical Low $141.25 Median $151.36 Typical High $269.15 | Professional | None | $141.25 | $151.36 | $269.15 |
Wellmark Setting Professional Modifier None Typical Low $302.00 Median $302.00 Typical High $302.00 | Professional | None | $302.00 | $302.00 | $302.00 |
4 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $63.10 Median $117.49 Typical High $123.03 | Professional | 52 · Reduced service | $63.10 | $117.49 | $123.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.12 Median $46.77 Typical High $48.98 | Professional | 53 · Discontinued | $25.12 | $46.77 | $48.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.05 Median $35.48 Typical High $37.15 | Professional | 55 · Aftercare only | $19.05 | $35.48 | $37.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.59 Median $23.44 Typical High $24.55 | Professional | 56 · Pre-op care only | $12.59 | $23.44 | $24.55 |
Where Iowa sits
The same service costs 2.8 times more in Montana than in Delaware. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Iowa· 10th of 51
$302
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.